Provider Demographics
NPI:1215929633
Name:MORIARTY, ANDREW M (PT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:MORIARTY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 E EMILE ZOLA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-4947
Mailing Address - Country:US
Mailing Address - Phone:602-296-7363
Mailing Address - Fax:
Practice Address - Street 1:5410 N SCOTTSDALE RD
Practice Address - Street 2:SUITE A-100
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-7016
Practice Address - Country:US
Practice Address - Phone:480-609-0822
Practice Address - Fax:480-609-0828
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5140225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist